Child health strategy encourages use of bed nets to combat malaria in Niger

Aliya Saadou, 26, holds her daughter Bassira on a visit to a health centre in Madarounfa, Niger.

By Michel Arsenault

MADAROUNFA, Niger, 28 April 2008 – Every night, Aliya Saadou, 26, makes sure that her three young children, including one-month-old Bassira, sleep under the safety of a bed net. Once treated with insecticides, a mosquito net is the best protection against malaria, which is endemic in Aliya’s village of Safo Tchikadji, located just 15 km south of Maradi, Niger’s second biggest city.

Ms. Saadou received the bed net from her local health centre as part of the Accelerated Child Survival and Development (ACSD) strategy, an intervention that aims to reduce Niger's under-five mortality rate, one of the highest in the world. Once Bassira has had all her vaccines against childhood illnesses – another facet of the programme – Ms. Saadou will be given a second bed net for her family.

Under the ACSD scheme, young children and mothers in Madarounfa District – one of the first two districts to benefit from this initiative – were among the first in Niger to receive free mosquito nets (and to achieve a significant improvement in vaccine coverage at the same time).

Ms. Saadou puts up the mosquito net to protect her child during the night.

Proper use of bed nets

While 69 per cent of Niger’s households have mosquito nets, there are still not enough nets to go around and they are not used widely enough. Usually, only the very youngest children benefit from proper sleeping conditions. Even though the number of malaria cases is falling, it remains the most common ailment among children brought to the health centre in Safo.

Once the mosquito nets have been distributed, it is important to make sure they are used properly. In earlier times, the nets often turned up in their original packaging at local markets. Sometimes, husbands take the nets away from their wives and children, and keep them for themselves.

Nowadays, the packaging is removed and the nets are marked with ink before being handed out.

Preventable child deaths

Ms. Saadou is only too aware of the threat posed by malaria: One of her sons died from the disease when he was only 18 months old. The death was all the harder to bear because she had previously lost a daughter, who died when only 17 days old due to severe diarrhoea. A small piece of pottery marks the spot near the house where the newborn was buried.

But Ms. Saadou believes her son's death was avoidable. “If he had slept under a mosquito net, he would not have caught malaria,” she says.

For now, Ms. Saadou is taking things easy. Bassira still spends all day sleeping, until her big brother Loukmanou comes home from school and starts making noise. She then wakes up and looks out from under the mosquito net. Under this delicate shield, her face still seems inexpressive. But her eyes are full of life.